HCFA's racial and ethnic data: current accuracy and recent improvements.

Using linked data from the Medicare Current Beneficiary Survey (MCBS), the authors assessed the accuracy of racial/ethnic classifications in HCFA's enrollment data base (EDB) before and after the 1997 effort to update the EDB. After the update, the sensitivity of the EDB was 97 percent for white persons and 95 percent for black persons, but less than 60 percent for all other categories. The positive predictive value was above 96 percent for white, black, and Hispanic persons, but below 80 percent for all others. There was some improvement in accuracy for white persons and black persons from 1991-1997, and larger improvements for the non-black minorities from 1996-1997.

Behavioral risk factor surveillance of aged Medicare beneficiaries, 1995.

The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing State-based telephone survey of adults, administered through State health departments. The survey estimates health status and the prevalence of various risk factors among respondents, who include both fee-for-service and managed care Medicare beneficiaries. In this article the authors present an overview of the BRFSS and report 1995 regional results among respondents who were 65 years of age or over and who had health insurance. The advantages and disadvantages of using the BRFSS as a tool to monitor beneficiary health status and risk factors are also discussed.

Evaluation of health, sanitation, and nutrition in Forces Command Child Development Centers.

In 1992, Forces Command had 42 Child Development Centers on 22 installations. We evaluated program compliance in the areas of health, sanitation, and nutrition using inspection findings from April 1991 through June 1992. Each program was rated on 20 items, using inspection checklists developed for this evaluation. We also surveyed Haemophilus influenza type b (Hib) vaccination records among enrolled children. Most programs and facilities were fully or partially compliant in most areas. By quantifying the inspection findings, we were able to identify compliance items that needed further attention. The most frequent problem area across all programs was documentation of child immunization and health records. For children between 13 and 60 months of age, 77.7% had records indicating appropriate vaccination against Hib. Comparisons with the prior year's findings indicated a trend toward improvement.

HIV instruction, HIV knowledge, and drug injection among high school students in the United States.

BACKGROUND: The prevalence of HIV-related behaviors and determinants of these behaviors among adolescents in the United States have not been well studied. METHODS: To determine the prevalence of HIV-related drug behaviors and to assess the effects of HIV-related school-based instruction and HIV knowledge on these behaviors, data were analyzed from a 39-item, self-administered questionnaire completed by a probability sample of all students in grades 9 through 12 in the United States. RESULTS: Usable responses were obtained from 8098 students. Of these, 2.7% (95% confidence interval [CI] = 2.3-3.2) and 1.7% (95% CI = 1.3-2.1) reported injecting illicit drugs ever and during the past year, respectively. Corresponding prevalences of needle sharing were 0.8% (95% CI = 0.5-1.1) and 0.5% (95% CI = 0.3-0.7). Regression analysis revealed that students with higher knowledge scores were less likely and males more likely to have ever injected drugs. HIV knowledge was similarly associated with other outcome measures of drug-injection behavior. Although HIV instruction did not directly influence drug-injection behavior independently of demographic characteristics, it was positively associated with HIV knowledge. CONCLUSIONS: While these results do not establish a causal relationship, they suggest that HIV knowledge and school-based instruction may play a role in maintaining low levels of drug-injection behavior among high school students.